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- Title
Clinico-hematological and Outcome Profile of Pediatric B-other-ALL and BCR::ABL1-like pre-B-ALL: An Integrated Genomic Study From North India.
- Authors
Peyam, Srinivasan; Bhatia, Prateek; Singh, Minu; Sharma, Pankaj; Sreedharanunni, Sreejesh; Sachdeva, Manupdesh S.; Naseem, Shano; Bansal, Deepak; Varma, Neelam; Thakur, Rozy; Trehan, Amita
- Abstract
BCR::ABL1-like B-ALL comprises a myriad of genetic lesions making its molecular diagnosis challenging in resource constraint settings. We enrolled 154 consecutive children with pre-B-ALL (group 1 [B-other-ALL: 37 patients and group 2 recurrent translocations/hyperdiploidy: 117 patients]). B-other-ALLs were evaluated for BCR::ABL1-like genetic lesions using an integrated genomic study (PACE approach supplemented with targeted RNA-sequencing). We observed a BCR::ABL1-like pre-B-ALL frequency of 9% (14 of 154) in the whole cohort. We observed that the sensitivity had increased significantly from 22% (8 of 37) using the PACE approach alone to 38% (14 of 37) in B-other-ALLs, with the integrated approach. Purpose: BCR::ABL1-like pre-B-ALL comprises a myriad of genetic lesions making molecular diagnosis challenging and expensive. Its frequency and outcome are less studied in resource-constraint settings. Methods: 154 pre-B-ALL cases (0-12 years) were enrolled as group 1 (37 cases of B-other-ALL) and group 2 (117 patients with recurrent translocations/hyperdiploidy). Group 1 was evaluated for BCR::ABL1-like genetic lesions and copy-number abnormalities (CNAs) as per our published PACE approach supplemented with targeted RNA sequencing. Results: BCR::ABL1-like frequency was 5.2% (8 of 154) and 22% (8 of 37) with the PACE approach alone in the whole and B-other-ALL cohort, respectively. The addition of targeted RNA-sequencing had led to the frequency increasing to 9% (14 of 154) and 38% (14 of 37) in the whole and B-other-ALL cohort, respectively. P2RY8::CRLF2, IGH::CRLF2, and RCSD1::ABL1 were noted in 8 (57.1%), 4 (28.6%), and 2 (14.3%) patients, respectively. CNAs were noted in 56.7% (21 of 37) of patients. The BCR::ABL1-like group had a significantly higher initial WBC count of > 50,000/mm[sup 3] (71.4%; P < .001) than group 2. The 4-year OS, EFS, RFS of group 1 was not statistically different from group 2, though RFS was borderline poor (84.2%, 51.7%, 56.9% Vs. 82.6%, 62.9%, 78% [P -- .42, P -- .53, P -- .059]). The 4-year EFS and RFS for BCR::ABL1- like cases was 70.7% and 76.6%, respectively. Conclusions: The sensitivity of detecting BCR::ABL1-like lesions had increased significantly from 22% using the PACE approach alone to 38% in B-other-ALLs with the integrated approach. Although outcomes were not statistically different, a higher percentage of relapses were noted in the B-other-ALL group.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2022, Vol 22, Issue 8, pe667
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2022.03.007